scholarly journals Challenges associated with physical assessments for people living with dementia: Modifying standard assessment protocols

2020 ◽  
Vol 8 ◽  
pp. 205031212091035 ◽  
Author(s):  
Gaynor Parfitt ◽  
Dannielle Post ◽  
Alison Penington ◽  
Kade Davison ◽  
Megan Corlis
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Coefficient Of Variation ◽  
Handgrip Strength ◽  
Residential Aged Care ◽  
Timed Up And Go ◽  
Retest Reliability ◽  
Sit To Stand ◽  
Test Retest Reliability ◽  
Minute Walk

Objectives: Regular physical activity for older adults as they age is important for maintaining not only physical function but also independence and self-worth. To be able to monitor changes in physical function, appropriate validated measures are required. Reliability of measures such as the timed-up-and-go, five-repetition sit-to-stand, handgrip strength, two-minute walk, 30-second sit-to-stand, and four-metre walk has been demonstrated; however, the appropriateness of such measures in a population of adults living with dementia, who may be unable to follow instructions or have diminished physical capacity, is not as well quantified. This study sought to test modified standard protocols for these measures. Methods: Modification to the standard protocols of the timed-up-and-go, five-repetition sit-to-stand, handgrip strength, two-minute walk, 30-second sit-to-stand, and four-metre walk was trialled. This occurred through modification of procedural components of the assessment, such as encouraging participants to use their hands to raise themselves from a seated position, or the incorporation of staged verbal cueing, demonstration, or physical guidance where required. The test–retest reliability of the modified protocols was assessed using Pearson’s correlation, and performance variances were assessed using the %coefficient of variation. Intraclass correlations were included for comparisons to previous research and to examine measurement consistency within three trials. Results: At least 64% of the population were able to complete all measures. Good test–retest reliability was indicated for the modified measures (timed-up-and-go = 0.87; five-repetition sit-to-stand = 0.75; handgrip strength = 0.94; two-minute walk = 0.87; the 30-second sit-to-stand = 0.93; and the four-metre walk = 0.83), and the %coefficient of variation (7.2%–14.8%) and intraclass correlation (0.77–0.98) were acceptable to good. Conclusion: This article describes the methodology of the modified assessments, presents the test–retest statistics, and reports how modification of the current protocols for common measures of physical function enabled more older adults living with dementia in a residential aged care facility to participate in assessments, with high reliability demonstrated for the measures.

scholarly journals The Automatic Assessment of Strength and Mobility in Older Adults: A Test-Retest Reliability Study

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 270 ◽  
Author(s):  
Daniel Collado-Mateo ◽  
Pedro Madeira ◽  
Francisco J. Dominguez-Muñoz ◽  
Santos Villafaina ◽  
Pablo Tomas-Carus ◽  
...  
Keyword(s):  
Older Adults ◽  
Intraclass Correlation ◽  
Timed Up And Go ◽  
Retest Reliability ◽  
Healthy Older Adults ◽  
Chair Stand ◽  
Stand Test ◽  
Chair Stand Test ◽  
Sit To Stand ◽  
Test Retest Reliability

Background: Simple field tests such as the Timed Up and Go test (TUG) and 30 s Chair Stand test are commonly used to evaluate physical function in the elderly, providing crude outcome measures. Using an automatic chronometer, it is possible to obtain additional kinematic parameters that may lead to obtaining extra information and drawing further conclusions. However, there is a lack of studies that evaluate the test-retest reliability of these parameters, which may help to judge and interpret changes caused by an intervention or differences between populations. Thus, the aim of this study was to evaluate the test-retest reliability of the Timed Up and Go test (TUG) and 30 s Chair Stand test in healthy older adults. Methods: A total of 99 healthy older adults participated in this cross-sectional study. The TUG and the 30 s Chair Stand test were performed five times and twice, respectively, using an automatic chronometer. The sit-to-stand-to-sit cycle from the 30 s Chair Stand test was divided into two phases. Results: Overall, reliability for the 30 s Chair Stand test was good for almost each variable (intraclass correlation coefficient (ICC) >0.70). Furthermore, the use of an automatic chronometer improved the reliability for the TUG (ICC >0.86 for a manual chronometer and ICC >0.88 for an automatic chronometer). Conclusions: The TUG and the 30 s Chair Stand test are reliable in older adults. The use of an automatic chronometer in the TUG is strongly recommended as it increased the reliability of the test. This device enables researchers to obtain relevant and reliable data from the 30 s Chair Stand test, such as the duration of the sit-to-stand-to-sit cycles and phases.

Physical function and all-cause mortality in older adults diagnosed with cancer: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Yasmin Ezzatvar ◽  
Robinson Ramírez-Vélez ◽  
Mikel L Sáez de Asteasu ◽  
Nicolás Martínez-Velilla ◽  
Fabricio Zambom-Ferraresi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Physical Function ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Timed Up And Go ◽  
Hazard Ratios ◽  
Inverse Variance ◽  
All Cause Mortality ◽  
Prospective Association

Abstract Background Physical function is an independent predictor of numerous chronic diseases, but its association with all-cause mortality in older adults diagnosed with cancer has received little attention. Objective The aim of this study was to conduct a systematic review and meta-analysis on the prospective association between physical function and all-cause mortality in older adults diagnosed with cancer. Methods Two authors systematically searched MEDLINE, EMBASE, and SportsDiscus databases. Prospective studies reporting associations of baseline physical function with all-cause mortality in patients aged 60 years or older diagnosed with any type of cancer were included. Hazard Ratios (HR) with associated 95% confidence intervals (CI) were extracted from studies for all-cause mortality and pooled HRs were then calculated using the random-effects inverse-variance model with the Hartung-Knapp-Sidik-Jonkman adjustment. Results Data from 25 studies with 8,109 adults diagnosed with cancer aged ≥60 years were included in the study. Higher levels of physical function (short physical performance battery, HR=0.44 95% CI, 0.29–0.67; I 2=16.0%; timed up and go, HR=0.40 95% CI, 0.31–0.53; I 2=61.9%; gait speed, HR=0.41 95% CI, 0.17–0.96; I 2=73.3%; handgrip strength: HR=0.61 95% CI, 0.43–0.85, I 2=85.6%; and overall, HR=0.45 95% CI, 0.35–0.57; I 2=88.6%) were associated with a lower risk of all-cause mortality compared to lower levels of functionality. Neither age at baseline nor length of follow-up had a significant effect on the HR estimates for lower all-cause mortality risk. Conclusion Physical function may exert an independent protective effect on all-cause mortality in older adults diagnosed with cancer.

scholarly journals Chronic Fish Oil Consumption with Resistance Training Improves Grip Strength, Physical Function, and Blood Pressure in Community-Dwelling Older Adults

Sports ◽  
2019 ◽  
Vol 7 (7) ◽  
pp. 167 ◽  
Author(s):  
Sang-Rok Lee ◽  
Edward Jo ◽  
Andy V. Khamoui
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Resistance Training ◽  
Fish Oil ◽  
Physical Function ◽  
Synergistic Effects ◽  
Handgrip Strength ◽  
Community Dwelling ◽  
Sit To Stand ◽  
Community Dwelling Older Adults

Fish oil (FO) has received great attention for its health-enhancing properties. However, its potential synergistic effects with resistance training (RT) are not well established. The purpose of this study was to investigate the effects of FO supplementation during 12-weeks of RT on handgrip strength, physical function, and blood pressure (BP) in community-dwelling older adults. Twenty-eight healthy older adults (10 males, 18 females; 66.5 ± 5.0 years) were randomly assigned to three groups: Control (CON), resistance training (RT), resistance training with FO (RTFO). Handgrip strength, physical function [five times sit-to-stand (5T-STS), timed up and go (TUG), 6-m walk (6MW), 30-s sit-to-stand (30S-STS)], and BP were measured pre- and post-intervention. ANOVA was used with significance set at P ≤ 0.05. Handgrip strength significantly increased in RT (+5.3%) and RTFO (+9.4%) but decreased in CON (−3.9%). All physical function outcomes increased in RT and RTFO. CON exhibited significantly decreased TUG and 30S-STS with no change in 5T-STS and 6MW. BP substantially decreased only in RTFO, systolic blood pressure (−7.8 mmHg), diastolic blood pressure (−4.5 mmHg), mean arterial pressure (−5.6 mmHg), while no change was found in CON and RT. Chronic RT enhanced strength and physical function, while FO consumption combined with RT improved BP in community-dwelling older adults.

scholarly journals Changes in Physical and Oral Function after a Long-Term Care Prevention Program in Community-Dwelling Japanese Older Adults: A 12-Month Follow-Up Study

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 719
Author(s):  
Yoshimi Iwao-Kawamura ◽  
Hideo Shigeishi ◽  
Shino Uchida ◽  
Shirou Kawano ◽  
Tomoko Maehara ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Health Program ◽  
Handgrip Strength ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
Term Care ◽  
Oral Function ◽  
Nutritional Guidance ◽  
Japanese Older Adults

Background: The aim of this prospective cohort study was to clarify changes in physical and oral function in older adults after completing a 3-month health program combining physical and oral exercise, oral health instruction, and nutritional guidance. Methods: Subjects were 34 women aged at least 70 years (mean age 79.2 years) in Bungotakada City, Oita Prefecture, Japan. Physical and oral function was investigated on the first day (baseline), at the end of the program, and 6 and 12 months after completing the health program. Physical function was measured using handgrip strength test, timed up and go (TUG) test and one-leg standing time test. Oral diadochokinesis test and repetitive saliva swallowing test (RSST) were employed to assess oral function. Results: TUG scores were significantly lower at 6 and 12 months than at baseline in participants aged ≥70 and <80 years. The repetition rate of the monosyllables /pa/, /ta/, and /ka/ was improved at the end of program in participants aged ≥70 and <80 years and increased to more than 6 times/second at 12 months. Conclusions: Our 3-month health program maintained improvements in oral and physical function in older women 1 year after completing the program.

Reliability and minimal detectable change of the 2-minute walk test and Timed Up and Go test in patients with total hip arthroplasty

2020 ◽  
pp. 112070001988861
Author(s):  
Ertugrul Yuksel ◽  
Bayram Unver ◽  
Serpil Kalkan ◽  
Vasfi Karatosun
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Minimal Detectable Change ◽  
Walk Test ◽  
Detectable Change ◽  
Timed Up And Go ◽  
Retest Reliability ◽  
Total Hip ◽  
Test Retest Reliability ◽  
Minute Walk

Purpose: Performance-based outcome measures are becoming increasingly important in health care. The 2-minute walk test (2MWT) and the Timed Up and Go test (TUG) are frequently used in clinical trials as performance-based tests in many diseases including osteoarthritis. The purposes of this study were: (1) to determine test-retest reliability of data for the 2MWT and the TUG; (2) to determine minimal detectable change (MDC) scores for the TUG and 2MWT in patients with total hip arthroplasty (THA). Methods: 37 patients, who had undergone primary THA, were included. Patients twice performed trials for the 2MWT and TUG on the same day. In addition to demographic data of patients, the Harris Hip Score, 2MWT and TUG scores were recorded. Results: The TUG and 2MWT showed excellent test-retest reliability. The Intraclass correlation coefficient ICC (2,1), Standard error of measurement (SEM) and minimal detectable chance at the 95% CI (MDC95) for TUG were 0.96, 0.59 seconds and 1.62 seconds respectively. The ICC (2,1), SEM and MDC95 for 2MWT were 0.96, 6.37 m and 17.56 m respectively. Conclusion: Clinicians and researchers can be confident that greater changes than 1.62 seconds for TUG and 17.56 m for the 2MWT over time represent a real clinical change in rehabilitation process in patients with THA. Both the 2MWT and TUG may assist in early identification of patients who may need additional rehabilitation to reduce the potential for poor outcomes after THA. Therefore, both of these tests can be used in a clinical setting with a small measurement error.

scholarly journals Duration or Timing? What is the Optimal Core for Older Adults to Engage in Moderate-to-vigorous Physical Activity to Prevent Disability?

2020 ◽  
Author(s):  
Ting-Fu Lai ◽  
Yung Liao ◽  
Chien-Yu Lin ◽  
Wan-Chi Huang ◽  
Ming-Chun Hsueh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Function ◽  
Gait Speed ◽  
Handgrip Strength ◽  
Vigorous Physical Activity ◽  
Total Duration ◽  
Functional Mobility ◽  
Linear Regression Models ◽  
Timed Up And Go

Abstract Background The positive association between the total duration of physical activity and performances of physical function may vary at different times of the day as circadian rhythm regulates individuals in response to external stimulations. We aimed to examine the association of timing-specific and overall moderate-to-vigorous physical activity (MVPA) with performances of physical function in older adults. Methods A cross-sectional analysis was conducted among 118 older adults (mean age = 70.0 ± 5.0 years). We assessed and identified timing-specific (morning: 06:01-12:00; afternoon: 12:01-18:00; evening: 18:01-24:00) and overall MVPA using a triaxial accelerometer. Different measures of physical function were evaluated including handgrip strength (by grip dynamometer), gait speed (five-meter walk test), basic functional mobility (timed up and go test), and lower limb strength (five times sit-to-stand test). Multivariate linear regression models adjusting for covariates were used to investigate the associations. Results Participants spent 0.4 hours in MVPA per day on average, half the time spent during the morning (47.7%), followed by during the afternoon (29.9%) and evening (21.6%). The time spent on overall MVPA was generally associated with better physical function performances. There was statistical evidence for the percentages of MVPA engagement during the morning ( B = 0.214, 95% confidence interval [CI] 0.001 to 0.428) and afternoon ( B = -0.273, 95% CI -0.518 to -0.027) associated with basic functional mobility but with contrary directions; the percentage of MVPA engagement during the evening was associated with less time spent in gait speed performance ( B = -0.237, 95% CI -0.468 to -0.006). Conclusions Our findings inform implications that the overall MVPA engagement was more important than timing-specific MVPA to older adults’ physical function performances. Strategies for accumulating time of MVPA is more practical and effective than encouraging to engage MVPA in specific timing for the enhancement of functional ability and therefore prevent disability among older adults.

scholarly journals Effect of a common UMOD variant on kidney function, blood pressure, cognitive and physical function in a community-based cohort of older adults

2021 ◽  
Author(s):  
Linda Elizabeth Villagomez Fuentes ◽  
Engi Abdel–Hady Algharably ◽  
Sarah Toepfer ◽  
Maximilian König ◽  
Ilja Demuth ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Physical Function ◽  
Kidney Function ◽  
Association Studies ◽  
Handgrip Strength ◽  
Community Dwelling ◽  
Digit Symbol Substitution Test ◽  
Genome Wide Association Studies ◽  
Timed Up And Go

AbstractIn genome-wide association studies, genetic variants in the UMOD gene associate with kidney function, blood pressure (BP), and hypertension. Elevated BP is linked to kidney function and impaired cognitive as well as physical performance in later life. We investigated the association between UMOD rs4293393–A > G and kidney function, BP, cognitive and physical function in the Berlin Aging Study II (BASE–II). Data of 1556 older BASE–II participants (mean age 68.2 ± 3.7 years) were analyzed. BP was determined by standardized automated measurements, estimated glomerular filtration rate (eGFR) by CKD Epidemiology Collaboration creatinine equation. Cognitive function was assessed by Mini-Mental State Examination and Digit Symbol Substitution Test, while physical function by Handgrip Strength and Timed Up and Go-Test. Association analyses were performed by covariance and logistic regression models adjusting for sex. G–allele carriers at UMOD rs4293393 exhibited significantly higher eGFR values compared to non–carriers (AA, 76.4 ml/min/1.73 m², CI: 75.7–77.2 vs. AG, 78.4 ml/min/1.73 m², CI: 77.3–79.5 vs. GG, 78.5 ml/min/1.73 m², CI: 75.4–81.7; P = 0.010), and a lower risk of eGFR < 60 mL/min/1.73 m2 (AG, OR: 0.63, CI: 0.41–0.97, P = 0.033). However, UMOD rs4293393 genotypes were not associated with BP, diagnosis of hypertension or cognitive and physical function parameters. Our data corroborate previous findings on the association of UMOD rs4293393-G with better kidney function in older adults. However, no association between UMOD and BP or physical and cognitive parameters in these community-dwelling older adults was detected.

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